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Pediatric problematic severe asthma: Recent advances in management

2021 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is the peer reviewed version of the following article, which has been published in final form at https://onlinelibrary.wiley.com/doi/10.1111/pai.13543. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. ;ISSN: 0905-6157 ;EISSN: 1399-3038 ;DOI: 10.1111/pai.13543

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Title:
Pediatric problematic severe asthma: Recent advances in management
Author: Scotney, E ; Burchett, S ; Goddard, T ; Saglani, S
Subjects: 1107 Immunology ; 1114 Paediatrics and Reproductive Medicine ; 1117 Public Health and Health Services ; adolescent ; Allergy ; BETA AGONIST ; child ; CHILDHOOD ASTHMA ; CLINICAL-OUTCOMES ; DOUBLE-BLIND ; FLUTICASONE FUROATE ; Immunology ; INHALED CORTICOSTEROIDS ; Life Sciences & Biomedicine ; management ; molecular phenotype ; PARALLEL-GROUP ; Pediatrics ; REFRACTORY ASTHMA ; RELIEVER THERAPY ; Science & Technology ; severe asthma ; SINGLE INHALER
Description: Problematic severe asthma remains a significant challenge to manage, accounting for the majority of healthcare utilization among children with asthma. The heterogeneity is recognized and the clinical phenotypes of “difficult-to-treat” asthma (DA) and “severe therapy-resistant asthma” (STRA) help to guide management. Recent evidence supports molecular distinctions between these phenotypes and shows poor correlations between peripheral and airway markers of inflammation, especially in STRA. Airway neutrophils in the context of childhood severe asthma have been explored, but their role in disease causation, protection, or as bystanders remain unknown, and thus, treatment implications are unclear. Several novel management strategies, including once-daily maintenance therapy, single-device maintenance and reliever therapy, and novel biological treatments are being increasingly used for DA and STRA. However, pediatric data for efficacy of novel treatments is scarce, and when available, is restricted to adolescents. The aim of this review is to highlight recent advances in objective biomarkers that aid stratification and management of childhood severe asthma and to highlight gaps in pediatric evidence. Specifically, the urgent need for efficacy studies to improve the management of problematic severe asthma in children younger than 12 years.
Publisher: Wiley
Creation Date: 2021-05
Language: English
Identifier: ISSN: 0905-6157
EISSN: 1399-3038
DOI: 10.1111/pai.13543
Source: Spiral

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Pediatric problematic severe asthma: Recent advances in management

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